Attach 3 - Experience_Questionnaire.docx
DOCX document 23 KB Posted
- Solicitation number
- 12444024Q0005
- Issued by
-
Department of Agriculture Forest Service
About this file
This document includes an experience questionnaire and details of a federal contract opportunity for recreational site operational grounds services. The opportunity is a firm fixed price IDIQ service contract with the Department of Agriculture Forest Service for grass cutting, trimming, edging, recreation area cleaning, toilet and shower building cleaning, and litter pickup at recreation areas on the Oakmulgee Ranger District. The contractor must provide all supervision, personnel, transportation, equipment, supplies, services, permits and licenses necessary to perform the work. The experience questionnaire requests information on the offeror's qualifications and past performance. Quotes must be submitted no later than March 29, 2024 at 5:00 PM and include a signed SF-1449 form along with completed Attachments 4, 5 and 7.
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Text version
EXPERIENCE AND PAST PERFORMANCE QUESTIONNAIRE
Instructions: Use Item No. 10 Remarks if extra space is needed to answer any item below. Answer all items.
1. Contractor’s Name, Address & Telephone Number.
2. Type of Business
| Company | Co-Partner |
| Corporation | Individual |
| Non-profit Organization |
| 3. How many years’ experience do you have in this Line of work? | Years | |
| 4. How many years’ experience as a Prime Contractor? | ||
| Years | ||
| Subcontractor? | Years |
5. List the projects your business has completed in the last three (3) years.
COMPANY NAME, ADDRESS , TELEPHONE NUMBER AND CONTACT
PERSON
| CONTRACT TYPE/PROJECT DESCRIPTION |
| CONTRACT AMOUNT |
| PERIOD OF PERFORMANCE/DATE COMPLETED |
| 1. | List all of your firms’ current contract commitments. |
| CONTRACT |
NUMBER
AWARD
AMOUNT
Contact Name, Address & Telephone Number Percent Completed Date Contract Completed
7a. Have you ever failed to complete any work awarded to you? Yes No 7b.
Has work ever been completed by performance bond? Yes No 7c.
If “Yes” to either item 7a or 7b above, specify reason(s) and location(s) why.
Solicitation
No.
1244402 Q
XXXX
Attachment
8. Organization structure that will be available for this project:
| a. Minimum No. of employees: | and Maximum No. of employees: | |
| b. Are employees regularly on your payroll? | Yes | No |
c. Specify equipment available for this contract:
9. List the experience of the principal individuals of your business
| NAME |
| PRESENT POSITION |
| YEARS |
EXPERIENCE
TYPE OF WORK
10. REMARKS
CERTIFICATION: I certify that all of the statements made by me are complete and correct to be best of my knowledge and that any persons named as references are authorized to furnish the Forest Service with any information needed to verify my capability to perform this project.
Signature Print or Typed Name Title Date Duns # Tax ID#
File details come from the government source that posted it. Updated .